A 78-year-old woman with a medical history of rectal cancer operated of LAR by Cecil approach with a loop ileostomy. She underwent an ileostomy closure and was discharged with no complications on the third postoperative day.

On the fifth postoperative day she returned to the Emergency department complaining of abdominal pain, diarrhea and nausea. The physical examination revealed generalized abdominal pain, without tenderness or signs of peritonitis.

The blood test revealed elevation of RCP and leukocytosis. With the clinical orientation of exclusion colitis the patient was kept in observation but she developed a fever (38.8ºC) and her abdominal pain persisted. Due to this, a CT Scan was performed, revealing acute appendicitis.

In the video, the red arrow shows us the appendix and the yellow arrow the anastomosis.